High Cholesterol Treatment Guidelines Based on Risk Categories-Topic Overview

High Cholesterol Treatment Guidelines Based on Risk Categories - Topic Overview

Knowing your risk of having a heart attack is important. It helps you and your doctor decide whether you should start taking medicine right away or whether you can first try lifestyle changes to lower your cholesterol.

Your doctor will use your health and family history to check your risk of a heart attack. You can find your risk by using the Interactive Tool: Are You at Risk for a Heart Attack? Use the percentage you get from the tool to find your risk category in the table below:

Your Risk Category
Risk category	Risk of a heart attack within 10 years
Highest (category I)	More than 20%
Moderately high (category II)	10% to 20%
Moderate (category III)	Less than 10%
Lower (category IV)	No coronary artery disease; 1 or 0 risk factors

Recommended treatments

Highest risk (Category I)

Keep LDL at less than 100.

Your doctor may want your goal to be lower, less than 70, based on your risk factors. Getting your cholesterol to less than 100, or less than 70, means:

Making changes in what you eat.
Getting more exercise.
Taking medicine, especially if you have coronary artery disease or other risk factors and need to get your LDL to less than 70.

You also may want to talk to your doctor about taking a low-dose aspirin each day. It may help reduce your risk of heart attack.

Even if you are taking medicines, a healthy lifestyle will help lower your risk of a heart attack. If you need to make healthy changes, a good place to start is the Therapeutic Lifestyle Changes (TLC) program. The program will help you eat better, exercise more, and lose weight if you need to. When you start to make these changes part of your daily life, you will be on the way to reducing your risk of heart disease and stroke.

Moderately high risk or Moderate risk (Category II or III)

Keep LDL at less than 130.

Getting your cholesterol to this level means:

Making changes in what you eat.
Getting more exercise.

You may have to take medicine too.

Check out the Therapeutic Lifestyle Changes (TLC) program. It can help you lower your cholesterol and your risk of heart disease and stroke.

Lower risk (Category IV)

Keep LDL at less than 160.

Starting on the Therapeutic Lifestyle Changes (TLC) program can help you keep your cholesterol low, along with your risk of heart disease and stroke. Medicines are optional, but you may consider them.

If you have diabetes

Keep LDL at less than 100.

Your doctor may want your goal to be less than 70, based on your risk factors.

People who have diabetes have a higher risk of heart attack or stroke than people who do not have diabetes. Heart disease is a leading cause of death in people with diabetes. Also, in people with diabetes:

Heart attacks occur earlier.
Heart attacks are more likely to cause death.

Getting your cholesterol to this level means:

Making changes in what you eat.
Getting more exercise.
Taking medicine.

Answer:

Desirable
0-199

Borderline
200-239

High
240+

Your level is currently

Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is optimal.

Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is near optimal.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is borderline high. If your LDL goes higher, your total cholesterol level could become Borderline High. Consider reducing the amount of foods you eat with saturated fats and increasing physical activity. If you get more exercise, your level of "good" HDL cholesterol may increase, which could also help to keep your levels of LDL and total cholesterol in check.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL. The HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is Very High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL because the HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is Borderline High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. But your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol is High, but your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol is High, but your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is Borderline High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe medication, such as statins. Following medication, dietary, and exercise instructions should result in improvements.

Your total cholesterol level is High, and your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe statins or other cholesterol-lowering medications.

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